National Provider Identifier [NPI]: |
1366433138 |
Last Name Of The Provider |
BENJAMIN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5201 WILLOW SPRINGS RD |
Street Address 2 Of The Provider |
SUITE 450 |
City Of The Provider |
LA GRANGE HIGHLANDS |
Zip Code Of The Provider |
605256537 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
2770 |
Number Of Medicare Beneficiaries |
1301 |
Total Submitted Charge Amount |
1485933 |
Total Medicare Allowed Amount |
512147.3 |
Total Medicare Payment Amount |
372312.67 |
Total Medicare Standardized Payment Amount |
340722.29 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2770 |
Number Of Medicare Beneficiaries With Medical Services |
1301 |
Total Medical Submitted Charge Amount |
1485933 |
Total Medical Medicare Allowed Amount |
512147.3 |
Total Medical Medicare Payment Amount |
372312.67 |
Total Medical Medicare Standardized Payment Amount |
340722.29 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
506 |
Number Of Beneficiaries Age 75 to 84 |
514 |
Number Of Beneficiaries Age Greater 84 |
232 |
Number Of Female Beneficiaries |
835 |
Number Of Male Beneficiaries |
466 |
Number Of Non Hispanic White Beneficiaries |
1143 |
Number Of Black or African American Beneficiaries |
103 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
39 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0873 |